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Bharti Airtel Limited (Mobile Services)

Name of circle AP

Date: 14.11.2014.

Sr DESCRIPTION
.

REMARKS

EXPO FREIGHT PRIVATE


LIMITED
10

Name of company having bulk connections

2
Number of Connections taken*
*details of mobile numbers to be attached as per Annexure I
Customer undertaking

I/We hereby confirm that we are using the Airtel Mobile connections and the user name along with their
designation is provided against these mobile numbers as per the annexure1 containing ________pages.
I will update you on any name change happening in future due to transfer of mobile numbers, within a week
of any such change.
________________________________________________________________
Customer Signature (Authorized signatory)

________________________________________________________________
Company Stamp

Bharti Airtel Limited (Mobile Services)


Name of Circle- A p
(To be filled in with all details and the same has to be signed by the concerned person as mentioned therein at
the time of inspection of premises)

Sr DESCRIPTION
.

REMARKS

1
2
3
4

14.11.2014

Date (DD/MM/YY) of the Premises visit


Name of company having bulk connections
Number of Connections taken*
Address as per the Documents submitted

EXPO FREIGHT PRIVATE LIMITED


10
D No. 46-19-5/1, 1st Floor, Visakha
Business Center, Mandavari Street,
Dondaparthy, Visakhapatnam - 530
016
Single Location

Premises Address (where connections being used) (Please select


on option)
6
Name and designation/department of the Person met during the G VENKATARAMANA / ACCOUNTS
EXECUITVE
premises visit
8374377222
7
Contact number of the person met during the premises visit
*details of mobile numbers to be attached & verified by the concerned person as per Annexure I
Customer confirmation / Undertaking required as given below.

1. I/We hereby confirm that I am / we are not using Airtel telecom facilities for running the application
services like tele-calling, tele-marketing, tele-medicine, tele-education, tele-trading, e-commerce,
domestic call centre, international call centre, network operation centre etc., which fall under OSP
registration/ License with DOT.
My / our OSP / Telemarketing Registration number is ... (Applicable only in
case of using Airtel telecom facilities for the above mentioned applications).
2. I/We confirm and undertake that the SIM provided to me is non-transferable and it shall not be further
assigned or on any other commercial basis to any unauthorized person. Further, I/We further undertake
that I/we shall be personally responsible for any misuse of the SIMs allocated to me/us and also liable
for proceedings that may be initiated by any of the Agencies of Government/DoT for any acts deeds &
things that may be done / caused to be done or alleged to have been caused or done by me/us from
the above mobile numbers and we will keep Bharti Airtel Limited indemnified against any such
proceedings.
3. I/We hereby confirm that any change in the user of mobile numbers, currently used by me / us shall be
duly informed within 7 [seven] days of any such change.
______________________________________________________________
Customer Signature (Stamp in case of Company)
_____________________________________________________________
Verifiers name and signature
________________________________________________________________
External agency/Verifying agency stamp

Bharti Airtel Limited <Name of Person>/<External Agency representative visiting the premises>
In case of any suspicion about the nature of business carried out / observed, the same has to be
brought to the knowledge of the following officers immediately along with complete details.
[1] Zonal Business Manager/ CSD AV Compliance Representative
[2] Regulatory / Legal Department

Annexure I
Sr.
No
1

Mobile
Number
8790855499

Company User
name
D SAJITH

2
3

8374277222
8374377222

4
5
6

9963004222
8008774333
8374075999

7
8
9
10

8374065999
9177199992
9618505222
8790545888

K VINAY KUMAR
G
VENKATARAMANA
V UPENDRA
T RATNKAR
S SATYA
SOMESWARI
P PRASAD
P VIJAYA KUMAR
P GAGAN
N KRISHNA

USER
DESIGNATION
BRANCH
MANAGER
ASST MANAGER
ACCOUNTS
EXECUTIVE
SR. EXECUTIVE
SR. EXECUTIVE
EXECUTIVE
EXECUTIVE
EXECUTIVE
EXECUTIVE
ASSISTANT

________________________________________________________________(all pages of annexure 1)


Customer Signature (Stamp in case of Company)
_______________________________________________________________( all pages of annexure 1)
Verifiers name and signature
________________________________________________________________(all pages of annexure 1)
External agency/Verifying agency stamp

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